Thrombotic Thrombocytopenic Purpura, Heparin-Induced Thrombocytopenia, and Disseminated Intravascular Coagulation

Crit Care Clin. 2020 Apr;36(2):357-377. doi: 10.1016/j.ccc.2019.12.006. Epub 2020 Feb 6.

Abstract

Hemostatic abnormalities are common among critically ill patients and are associated with a high risk of bleeding. The abnormalities range from isolated thrombocytopenia or prolongation of global coagulation assays to complex disease states, such as thrombotic microangiopathic syndromes, and can be associated with a wide range of conditions, including trauma, surgery, acute disease processes, cardiopulmonary bypass, and exposure to drugs and blood products. Prompt identification of underlying causes is important because treatment strategies vary. Moreover, prompt initiation of both supportive and specific treatments is vital to decrease the morbidity and mortality in the intensive care unit.

Keywords: Caplacizumab; Heparin; ICU; Microangiopathic hemolytic anemia; Plasmapheresis; Rituximab; Thrombocytopenia; Thrombotic microangiopathy.

Publication types

  • Review

MeSH terms

  • Anticoagulants / adverse effects*
  • Critical Illness*
  • Disseminated Intravascular Coagulation / complications*
  • Disseminated Intravascular Coagulation / therapy
  • Heparin / adverse effects*
  • Humans
  • Purpura, Thrombotic Thrombocytopenic / complications*
  • Purpura, Thrombotic Thrombocytopenic / therapy
  • Risk Factors
  • Thrombocytopenia / chemically induced
  • Thrombocytopenia / etiology*
  • Thrombocytopenia / therapy

Substances

  • Anticoagulants
  • Heparin